Simulation-based training allows for training of our handling of complex situations. We simulate defined medical situations such as an intraoperative cardiogenic shock, complications during childbirth, or the management of multiple injuries in the trauma bay. During training, we can do things barely possible in the real clinical setting: test different approaches and reflect on their consequences in the debriefing. Similarly to other high-risk industries such as aviation, we can improve in critical situations and invasive procedures without risking harm of patients.
Learning in the simulated setting
Learning in the
simulated setting is different to traditional learning at school: it is
based on the learners’ previous experience, applied, and sustainable.
Learners make specific experiences in the simulated environment which
have relevance in their personal clinical setting. Some learners can
experience participating in the scenario and watch their videotaped
actions afterwards, while others can observe the interactions employing a
video live-feed and recording equipment. These observations are an
essential component of the ensuing discussion in which thoughts, actions
and pathways are analysed for their success or need for improvement.
Results of these debriefings can be directly implemented in the
succeeding scenarios – hence, simulation training is highly suited for
adapting habitual but ineffective routines. By identifying the reason
for refraining from correcting the faulty habit, we can identify the
required steps to make the improvement, rather than continuously being
made aware of the mistake. For example, inefficient cardiac massage in
resuscitation can be improved by introducing a regular and coordinated
exchange of compressors.
Simulation cannot reproduce reality in
its entirety, and learners’ behaviour differs between simulated
scenarios and real life cases. Hence simulation trainings are not
examinations, and an introduction to the methods and unfamiliar
equipment is an essential opening component of all trainings. For this
reason, in each training we
take sufficient time to introduce the learners to the simulation
learning environment and to support them in engaging with this
environment. We are convinced that although the technical
surroundings contribute to the success of trainings, it is particularly
the type of training, the quality of debriefing, and the institutional
support from clinical directors that allow for training success.
skill training is better suited for the practice of single, technical
components such as cardiac massage. As teamwork plays an outstanding
role in medicine, simulation training is especially suited for training
complex treatments in teams, such as reanimation during the treatment of
multiple injuries. Among others, we are using the crisis resource management principles (CRM) as a tool for managing complex, stressful situations in teams.